2020 ANNUAL REPORT EASTERN BAY PRIMARY HEALTH ALLIANCE

EBPHA | GENERAL PRACTICE | COMMUNITY

Contents

BACKGROUND...... 2 INTERIM CHAIRMAN’S REPORT...... 3 CHIEF EXECUTIVE’S REPORT...... 5 BOARD MEMBER BIOGRAPHIES...... 7 STRATEGIC INTENTIONS 2018 – 2020...... 10 THE YEAR IN NUMBERS...... 11 OUR GENERAL PRACTICES...... 15 MEDICAL HUB...... 17 PROGRAMMES TO IMPROVE ACCESS...... 18 COMMUNITY SERVICES...... 19 SERVICE SHOWCASE...... 21 SERVICE SUCCESSES...... 23 FINANCIAL STATEMENTS...... 26

EBPHA | GENERAL PRACTICE | COMMUNITY Background

The Eastern Bay Primary Health Alliance (EBPHA) is a Services delivered by the EBPHA are in place to Primary Health Organisation (PHO) that is funded by improve and maintain the health of the Eastern Bay the District Health Board and others to population. The aim is to ensure General Practice support the provision of essential primary health care services are better linked with other primary health services either directly or through General Practices services to ensure a seamless continuum of care with or community Health Providers to the people of the a particular focus to manage long-term conditions . and reducing inequalities.

EBPHA is a Charitable Trust incorporated under the Charitable Trust Act 1957 and registered under the Charities Act 2005 on the 27th July 2010.

The main frond represents the Eastern Bay Primary Health Alliance. With the smaller fronds representing our Providers that are in partnership with EBPHA.

Kotahitanga mo ngā iwi katoa Mana atua, mana tūpuna, mana whenua, mana tangata

2 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Interim Chairman’s Report Lance McNicholas

What a year 2020 has been. It’s safe to say that Whakaari / White Island COVID-19 has been a disruptive and seminal event. Amid the significant challenges, our General Practices Our thoughts are with the families and loved swiftly responded to ensure their clinics remained ones affected by the tragic volcanic eruption on operational and patient safety was at the forefront Whakaari / White Island as we approach the one-year of care. Clinicians adopted virtual/phone consults anniversary of the tragedy. and many practices have seen the benefits of virtual The response from the EBOP primary and secondary consults and have continued to provide this service. health services was exemplary. All of those who assisted in the disaster response should be commended; particularly the early responders, the “Concentrate on the future structure Whakatāne Hospital team, GP’s, volunteers, and wider and format of an integrated health and health team. Since the eruption, a key focus of the disability system.” EBPHA has been on supporting the victims, their families and the staff affected by the tragedy through CBAC (Community Based Assessment counselling. Clinics)

Drive-through CBAC clinics were set up throughout Health and Disability the Eastern Bay of Plenty in Ōpōtiki, Kutarere, System Review Tōrere, Whakatāne, Kawerau, Murupara, Waimana, The Final Report – Pūrongo Whakamutunga was Rūātoki, Waikaremoana and Ruatāhuna. The released in June 2020. The report broadly focusses remote mobile CBAC clinics ensured small and rural on the following changes: communities had access to COVID-19 assessment; and incorporated wrap-around services such as flu • A health sector based around the health needs of vaccinations and immunisations. The drive-through local districts and their populations. COVID assessment clinics were set up by Te Puna Ora • Ensuring the system is integrated and deliberately o Mataatua and Eastern Bay Primary Health Alliance plans with a longer-term focus. with support from Bay of Plenty District Health Board • A commitment to embedding Te Tiriti o Waitangi (BOPDHB), local iwi and hapū. Thank you to all of into the health sector. those who were involved in the set up and staffing of these CBAC clinics, from GP’s, nurses, healthcare assistances, administration and students.

EBPHA | GENERAL PRACTICE | COMMUNITY 3 • A focus on addressing structural inequalities in Mr. Ken Whelan who gets access to health services, and in health outcomes of different groups in society. The previous Chair Ken Whelan reported that 2019 had been a tumultuous year for the EBPHA and the • A shift in understanding primary care from a focus organization needed to hit reset. Thankfully with on general practitioner services to a much broader Ken’s guidance EBPHA is now strengthened and range of community-based services. resilient. The Board would like to thank Ken for his In a nutshell, the Simpson Report envisages a health commitment and contribution to the restructure of system which advances the health of all people, not EBPHA and wish him well in his new position as Chair, just those who actively seek out health services. The Whanganui District Health Board. report recommends changes that would most likely Summary threaten the existence of PHOs or transform them into different entities. The number of DHB’s will also Finally, I’m proud of how the EBPHA board has been reduce from 20 to 8-12 over the next 5 years. No transformed. The Board now has two doctors (Dr significant changes will be made before the election, Chris McKnight GP, and Dr Cecile De Groot GP) and and the structural reforms will be implemented over one surgeon (Mr. Nigel Giles, Orthopedic Surgeon) several years. giving us excellent representation of both primary and secondary health services. Also, we have strengthened our Iwi representation on the board BOPDHB Two PHO Policy with Dickie Farrar, CEO Whakatōhea. I would like to acknowledge the work of the EBPHA board who have This year the EBPHA faced a merger with the Western worked so hard in very difficult circumstances to Bay of Plenty Primary Health Organization. “Small support our practices through these most challenging into Big” is never good for Small and what is intended of times and I look forward to what next year brings. as a merger organically transforms into a takeover. Thankfully the new BoPDHB Board has parked this option as we concentrate on the future structure and format of an integrated health and disability system. Lance McNicholas Interim Chair Plans for future initiatives.

These challenging times also bring forth opportunities for innovation, and as EBPHA chair I look forward to seeing health care made more accessible especially amongst our rural and high needs populations through greater utilisation of community services, virtual and outreach clinics and greater use of I.T.

4 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Chief Executive’s Report GREIG Dean

I am very proud to lead the EBPHA Team who have Our purpose as a Primary experienced significant professional and personal Health Alliance (PHA) is challenges over the past twelve months that no one to ensure that we have could have predicted. The Eastern Bay of Plenty is capability and resources a small and proud community that prides itself on imbedded in the Eastern Bay so we can continue to supporting each other in the face of adversity and be consumer -focused, flexible, and adaptable to that resilience and aroha was demonstrated on the servicing our community’s needs. 9th December with the eruption of Whakaari / White Over the course of the year, we have strived to Island. ensure General Practice services are better linked The EBPHA, Eastern Bay General Practices, Ngāti Awa, with other primary health services to ensure a Whakatāne Hospital, District Council, Civil Defence, seamless continuum of care by providing greater BOPDHB, NZ Police, St John, many other local and representation of General Practice at governance national agencies were at the forefront of the rescue level. This has strengthened our connection to and recovery efforts. This tragedy demonstrated the Practices in the Eastern Bay and ensured a strong compassion and spirit of our community, “he iwi voice is being heard at a Governance level. kotahi tātou” (we are one people). Over the past year, the voices of our Board and On behalf of the EBPHA whānau, we would like to Leadership Team have been crucial in the ongoing thank you all for your tireless work as we continue to discussions with the BOPDHB around a different support those affected by this tragedy. future for the Bay Of Plenty health system, building on relationships strengthened through the Whakaari/ COVID -19 White Island and Covid-19 experiences and Let me first acknowledge the work undertaken by our opportunities arising from the Health and Disability COVID-19 response team led by our Clinical Director, Review. Rachel Shouler and the ongoing support provided by In particular, reference needs to be made to our Te Puna Ora o Mataatua who opened a Whakatāne Chairman at the time, Ken Whelan and his successor, based testing station in early February. Planning Lance McNicholas who demonstrated great scenarios for COVID-19 indicated that without leadership and guidance during a significant period additional primary care and hospital facilities, we of uncertainty. would be unable to cope with the surge in demand for services. The shifts signalled in the Health and Disability Review (H&DS Review) including leadership and an Given the fast-changing nature of this challenge, emphasis on locality planning and networks has also community-based assessment centres (CBACs) were contributed to the change in context for the BOPDHB established to help slow COVID-19 transmission by regarding their “TWO PHO” policy. It is likely that a separating, as much as possible, those with COVID-19 wider leadership group will emerge which makes symptoms from others requiring primary care enforcing the two PHO policy a lot less relevant in services. In addition, mobile CBACs provided greater this new environment. access to our more remote communities.

EBPHA | GENERAL PRACTICE | COMMUNITY 5 Vision Healthy Whānau, Healthy Lives

It continues to be our view that, that the greatest Mission opportunity we have to improve patient experience To lead community health care and to deliver greater equity, efficiency and value from health delivery systems in the Eastern Bay is to address the fragmentation of existing services that serve the same population of 52,000. Values We look forward to working with others to develop and operationalise an integrated health service in the Eastern Bay, with Primary Care / Iwi /Secondary and Community. I am very proud of our organisation and Aspirational would like to record my thanks to all the hard working to be passionate (care) about all we do, and imaginative staff of the EBPHA, to our Board, to thereby delivering superior value to our the General Practice Teams, Community Partners and communities. We aspire to be recognised as to other colleagues throughout the Eastern Bay. an innovative health leader.

“Focused, flexible, and adaptable to servicing our community’s needs.” Respect to respect all individuals, value their contributions, and recognise the importance of diversity. We will work corroboratively with all health Providers, communities and sectors to ensure everyone can enjoy a healthy life.

Greig Dean Chief Executive Excellence to be our best in everything we do. We will deliver high quality services for the best possible outcomes.

WE ARE EASTERN BAY PRIMARY HEALTH ALLIANCE

6 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Board Member Biographies

Fiona Wiremu – Deputy Chair I am from Ngai Tūhoe (Ngāti Hāmua & Te Mahurehure) and Ngāti Ranginui (Ngai Tamarāwaho) and am proud to hold a number of governance roles across the health sector - (Māori/Indigenous and Western) including Chairperson of the Finance and Audit Committee at Eastern Bay Primary Health Alliance and trustee; Chairperson (Med Central) Whakatāne Medical Practice and Director; Chairperson Te Puna Ora o Mataatua and trustee; Te Whakareia: Bay of Plenty Community Health Alliance, Board of Chairs.

As a lecturer of indigenous business at Te Whare Wānanga o Awanuiārangi, I support individuals and groups to develop enterprise and sustainable economies. The areas of research include Mātauranga Māori (Māori knowledge) inclusive of language, culture and identity; Whai Rawa (Māori economies); Te Tai Ao (The Natural Environment); Mauri Ora (Human Flourishing and Wellbeing); and Māori community self-development initiatives inclusive of whānau (family), hapū (sub-tribe) and iwi (tribe) development.

Linda Steel – Iwi Representative In both my personal and professional life, I do everything with integrity and believe that I am trustworthy and loyal. My whānau is where I draw my strength from during the challenging times and I use my life experiences to help me make decisions and offer practical solutions to challenges that may arise.

I enjoy reading and music, entertaining whānau and friends, watch sports and am a complete petrol-head.

After living in Sydney, Australia for 30 years, I moved home and am now the CE of Te Ao Hou Trust in Ōpōtiki.

Angela Jackson – Community Representative I have been part of the Eastern Bay Primary Health Alliance Board since November 2014 and have moved from a Clinical Representative to a Community Representative.

I have worked as a Radiation Therapist in Wellington and Waikato Hospitals and, more recently, I am a Support Coordinator for the Sweet Louise Foundation tasked with linking whānau with services and support with a focus on mental health and wellbeing. I am married with two children and live in the Whakatāne area.

EBPHA | GENERAL PRACTICE | COMMUNITY 7 Shaneen Simpson-Almond – Iwi Representative

I’m a Maori Development Specialist, employed as a Senior Regional Public Servant currently seconded from Ministry of Maori Development to Ministry of Business, Innovation and Employment as Contract Manager for the Eastern Bay of Plenty Provincial Growth Fund Projects.

I’m an enthusiastic motorsports spectator and I certainly enjoy V8, F1, Nascar and Motocross sports. I’m the youngest sibling of 10, I’m married with three grown children and four mokopuna.

My goal for EBPHA is to provide advocacy for the health and wellbeing of our community and to ensure we are connected and partnering with all agencies and professionals to provide an effective primary health service to all people of the Eastern Bay of Plenty.

Dickie Farrar – Iwi Representative Whānau and extended whānau are most important to me. I enjoy being with my children, grandchildren and have interests in fishing, arts and crafts, gardening, re- purposing furniture and small renovation projects.

As Practice Owner/Director for Te Pou Oranga o Whakatōhea and as an EBPHA Board member, my goal is to remain relevant to the community and to the people we serve. We must continue to fully support and advocate on behalf of General Practice to ensure adequate funding based on practice and patient needs.

Erin Beeler – Clinical/Community Representative I was born and raised in the Eastern Bay of Plenty, and now am a mother of 3 – Lila (9), Chloe and Olivia (3). I am due to complete my Master’s in Health Practice at the end of this year with my thesis focusing on the recruitment and retention of the rural workforce.

8 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Chris McKnight – Clinical Representative Chris was born in Edinburgh and grew up on the East coast of Scotland. He has worked as a medical registrar in the Hawkes Bay when he first came to New Zealand on sabbatical during his GP training. Chris, and his wife Joanne, soon realised that New Zealand was where they wanted to settle and raise a family. Now a father of 3 kiwi girls, he has found they take up most of his spare time.

Now as an owner/operation of the Ōhope Beach Medical Centre, he has an interest in the wide variety a general practice offers. He has a particular interest in the skin cancer detection and treatment, men’s health, and teaching medical students who he often meets at the practice.

Cecile De Groot – Clinical Representative I was born and bred in South Africa hence I did my medical training in a very multi- cultural setting.

We came to New Zealand in 1991 and I initially worked in the Bluff, but we were looking for the sun. So, I moved to Edgecumbe and have been working as a GP ever since. My 3 children have grown up in the Bay.

I love Riverslea Medical Centre and we have a fabulous team who love to serve this great community.

Nigel Giles – Clinical Representative Professional interests in Orthopaedic surgery with 25 years expertise in joint replacement and sports injury surgery. I am currently acting as clinical lead for the Whakatāne Hospital.

I moved to New Zealand, and particularly rural New Zealand, to give my family the fantastic opportunity of living in a clean, green, multicultural society. This has also supported my other interests - cycling, skiing, boating; well, anything involving the outdoors and interacting with the environment.

My wife Karen is a physiotherapist, and we have 3 children – twin boys Callum and Ashley aged 15, and Daughter Zoe aged 13 all schooling in Whakatāne.

EBPHA | GENERAL PRACTICE | COMMUNITY 9 Strategic Intentions 2018–2020 Eastern Bay Primary Health Alliance (EBPHA) Philosophy

Respect for kotahitanga mo ngā iwi katoa. Mana Atua, Mana Tūpuna, Mana Whenua, Mana Tangata

our Vision Healthy Whānau Healthy Lives Our Impact Our Impact EBPHA understands Improved health status the aspirations and needs of the Eastern Bay of of varying general Plenty population practice models Our Outcomes Our Outcomes

Effective and Iwi, Community, whānau collaborative relationships have the knowlege to take with General Practice responsibility for their own health and well-being our Values our Mission WE ARE EBPHA To lead community Aspiration health care Respect Excellence Our Outcomes Our Outcomes

Community Health Services Excellent relationships are future focused, with communities interwoven and and Providers sustainable Our Impact Our Impact EBPHA understands the Eastern Bay of Plenty needs and aspirations residents have access of their different to high quality health communities and services Providers

EBPHA will develop and deliver effective and EBPHA is committed to reducing these inequalities equitable primary care services that meet the needs through ensuring there is an equity based and of our population. As a region the Eastern Bay of evidence informed approach to our service delivery. Plenty experiences persistent health and social This will ensure those with the greatest need receive inequalities particularly for Māori, children and the services and support they require. people living with long-term chronic conditions. The EBPHA Annual Plan will identify those particular areas we will direct our resources on to give effect to our impact and outcomes.

10 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT The year in Numbers

56% 36% 18% 73% 56% 747

EBPHA | GENERAL PRACTICE | COMMUNITY 11 COVID-19 and Community-Based Assessment Centre (CBAC) Numbers

With the arrival of the COVID-19 virus, EBPHA led, managed and set-up the CBACs and mobile testing stations for the Eastern Bay during the initial crisis and during the re-emergence of COVID-19 throughout the region. These were supported and enhanced by close working relationships with Te Puna Ora o Mataatua services and staff.

With so many health and community service providers working together to alleviate the spread and effect of COVID-19 on the Eastern Bay; this led to greatly improved relationships between both primary health services, secondary health services, practices and other community health providers. Health workers in all roles; across all sectors stepped up and helped in whatever capacity they could.

Practices demonstrated their flexibility and commitment by changing the way they worked: carpark consults, strict Infection Control requirements, phone and video consultations during lockdown. They managed to cope with losses in revenue, services, supplies and staffing.

From the initial start in March 25th to the 30th of June, over 4,000 people presented to CBACs, testing stations or practices for COBVID-19 testing.

• Over 3,100 people were assessed and

• Over 2,580 swabs taken.

EBPHA would like to acknowledge and thank all those involved for all the hard work, dedication and professionalism during this troubling and unsettling time.

12 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT EBPHA | GENERAL PRACTICE | COMMUNITY 13 2020 Practice Funding

10% Church Street Surgery

16% Kawerau Medical Centre

7% Whakatāne Med Central

7% Ōhope Beach Medical Centre

15% Riverslea Medical Centre

8% Tāneatua Medical Centre

18% Tarawera Medical Centre

7% Toi Ora Health

13% Whakatōhea Health Centre

11% Church Street Surgery 10167151813L 12% Kawerau Medical Centre

8% Whakatāne Med Central

7% Ōhope Beach Medical Centre

19% Riverslea Medical Centre

6% Tāneatua Medical Centre

23% Tarawera Medical Centre

7% Toi Ora Health

8% Whakatōhea Health Centre

14 2019 EASTERN BAY PRIMARY HEALTH11 ALLIANCE - ANNUAL REPORT 128719623L Our General Practices

Under the PHO services agreement, EBPHA provides EBPHA would like to acknowledge the hard work, a set of essential primary care services through dedication and effort General Practice practitioners Contracted Provider agreements with our 9 General (GPs), nurses and operational staff have undertaken Practices. The benefits of this partnership are that throughout a demanding and busy year impacted by Practices receive capitation funding based on their the Whakaari eruption, COVID-19 and lockdown. enrolled population and their patients are able to Practices have risen to these challenges by changing access some services for free. Eight of our 9 Practices the way they worked and continuing to meet the have Very Low Cost Access (VLCA) status due to 73% complex health needs of their patients. It is very of their enrolled population being “high needs”. This much appreciated by EBPHA and the wider Eastern means they receive additional funding to allow for Bay community. subsidised consultations for their patients. This year, EBPHA in recognition of the difficulties operating under COVID-19 and lockdown, funded its practices an additional $450,000 shared equally amongst practices.

10167151813L 7,459 154,230 1,321

547 1,987 $450k

11128719623L EBPHA | GENERAL PRACTICE | COMMUNITY 15 TOI ORA HEALth LTD

Whakatōhea Riverlea Medical Health Centre centre

$6.6m

Tarawera Medical Centre

16 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Ōpōtiki Medical Hub

TOI ORA HEALth LTD

The Ōpōtiki Medical Hub (the Hub) is a collaboration • Improved medical service for all patients (locals between the three Ōpōtiki General Practices: and visitors). Whakatōhea Health Centre; Church Street Surgery; • Increased utilisation of the Ōpōtiki Health Centre and Toi Ora Health. facility. • Continued free access to the nurse led service, The practices operating as the Hub have a shared with nurses working under a range of standing vision to build a sustainable, flexible, responsive orders, and supported through access to on-call GP service that meets the acute primary medical • Face to face consultations with a GP will incur a demand in the Ōpōtiki District. fee (free for under 14s). The Hub operates 8am – 10pm daily, including • Increased treatment options available after hours weekends and public holidays. and during weekends/public holidays. The Hub nurses operate a comprehensive range • Integrated, locally provided service supports low of standing orders and clinical pathways. They are health literacy and high deprivation community, supported by an on-call GP. All nurse consultations as it acts as an extension and supporting arm of are free, as are standing orders medication, however the patient’s medical home. should a GP be required to attend or the patient not • Standardised clinical pathways, staff training, be a NZ citizen then fees apply. standing orders and General Practice support create improved sustainability of medical services The Hub is currently working well through: in Ōpōtiki. • Reduces barriers, improves access and timely EBPHA would like to acknowledge the commitment response for acute patient presentations. of owners, practice managers and staff of the three • Access to medication after hours. Ōpōtiki Practices, who have worked tirelessly to • Reduces unnecessary and avoidable presentations develop the model, engage staff, provide clinical to Whakatane Emergency Department. governance and operational oversight of the Hub.

Local people providing local solutions

EBPHA | GENERAL PRACTICE | COMMUNITY 17 Programmes to Improve Access (PIA)

The EBPHA continues to support General Practice Practices are able to choose from a range of and their patients through the provision of PIAs. options in the Flexible Patient Fund e.g. supporting Over 17,780 financial claims were made by General patients experiencing financial hardship, long-term Practices, this was a 11% increase from the previous condition management, complex consultations, year. intensive management of conditions, pneumovax immunisation, mental health, breast screening Within the programme, the Flexible Patient Fund PIA enrolments and many other options. provides the General Practice with the flexibility to choose to fund what their patient needs.

flexible patient Cardiovascular Risk fund (FPF) Assessment Youth Health Check

Smoking Cessation Palliative Care Support Cervical Screening

18 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Community Services

The EBPHA delivers 22 contracted health services across the Eastern Bay of Plenty to approximately 54,000 people. Many of these services are enhanced through the support and collective effort of health and community organisations working with EBPHA within both the Eastern and Western Bay of Plenty.

We would like to specifically acknowledge the following organisations:

• He Tohunga Ora mo Rangitaiki • Te Manu Toroa Trust • Te Wheke Atawhai • Ngā Mataapuna Oranga PHO • Te Puna Hauora • Tuwharetoa Ki Kawerau Health, • Te Ao Hou Trust • Te Puna Ora o Mataatua Education and Social Services • Te Ika Whenua Hauora • Te Tohu o te Ora o Ngati Awa • Western Bay of Plenty PHO • Medical Centre • Te Uru Taumatua Tūhoe • Whakatōhea Māori Trust Board Many Community Health Providers also deliver out-sourced services for EBPHA and they do a fantastic job meeting specific needs of our population.

Community SERVICE Providers PROVIDER

Chronic Obstructive Disability Resource Centre Pulmonary Disease Management Community Podiatry Service Podium Podiatry Diabetes Retinal Screening Services Tauranga Eye Specialists Integrated Case Management – Opōtiki Te Ao Hou Trust Green Prescription Sport Bay of Plenty Tūwharetoa Ki Kawerau Health, Kawerau Rheumatic Fever Prevention Education and Social Services EBPHA, Western Bay of Plenty PHO, Regional Childhood Immunisation Ngā Mataapuna Oranga PHO, Support Services Community Health 4 Kids Ōpōtiki Nurse Led Acute Demand and Ōpōtiki Medical Hub Afterhours Service Edgecumbe College Ōpotiki College Tarawera High School School Based Health Services Te Kura Māori-ā-Rohe o Waiohau Whakatāne High School Trident High School

EBPHA | GENERAL PRACTICE | COMMUNITY 19 Snapshot of services

12,180 Contacts with patients or clients were made by staff of EBPHA 3,352 visits were made by high school students to School Based Health Service nurses and GPs assessments for psycho-social health and wellbeing, hearing, vision, chronic illness was carried out 185 with high school Students by the School Based Health Service 818 sexual health consults were carried out by School Based Health Service nurses 394 injuries and accidents were treated by School Based Health Service nurses 2,324 throat swabs of children were taken by the Kawerau Rheumatic Fever Prevention team skin assessments of children were carried out and 668 healthy skin packs were given out by the 1,030 Kawerau Rheumatic Fever Prevention team to prevent serious skin infections from occurring

children from Kawerau and Whakatāne communities were identified as having a Strep A throat 310 infection and at risk of developing Rheumatic Fever

clients were seen mostly in one-on-one sessions or in group therapy sessions by the Primary Health 1,834 Counselling service

vaccinations were completed across the Bay of Plenty by the Regional Childhood Immunisation 1,506 Support Services

children in rural and isolated communities received their vaccinations from the Outreach 490 Immunisation Service 1,418 priority women were screened for cervical cancer by General Practices 1,245 vaccinations were given by the Outreach Immunisation Service 656 smokers choose to enrol into EBPHA’s Hāpainga Stop Smoking Service across the Bay of Plenty smokers with a target quit date managed to quit within 4 weeks in EBPHA’s Hāpainga Stop Smoking 175 Service: equating to a 57% quit rate

people were assisted and navigated through EBoP health services by the Integrated Case 611 Management (ICM) services 567 clients were seen in one on one sessions or group sessions by Community Dietitians 235 people attended long term conditions self-management classes minor skin surgeries were carried out by GPs to detect and prevent Melanoma and non-melanoma 202 skin cancer 136 visits to patients were made by GPs to manage wound care Pacific fānau (families) were supported and navigated through health services by the Pacific Island 25 Community Service. 522 home visits were made, and staff attended 319 meetings with health, community agencies and clinicians in support of families

20 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Service Showcase Kent Abbot

Kia ora koutou katoa, my name is Kent Abbot. I was The Men’s Group, which born and raised in Whakatāne with my two brothers runs every first and third and younger sister. I attended Waikato University Tuesday of the month for six years completing a master’s in psychology in 6pm – 8pm, has been 2012 before spending five years in Perth, Australia great to be a part of. This working in mental health and then two and a half space allows men to come years in Vancouver, Canada. Very glad to be home and together and initiate the have always had the urge to work and support people content of the sessions from our community and surrounding areas. themselves. At times we have outside speakers I feel privileged to be part of the Eastern Bay come in to speak on issues the men would like to Primary Health Alliance Team. It is a workplace that know more about. The sessions are very informal, I feel very comfortable in being myself, feel very and discussions range from the best local fishing supported and motivated to add to the great work spots, suicide, cancer, rugby, alcohol, relationship that is already being undertaken. I have found the issues, anger, boxing, and pies. It provides a safe, non- role of counselling challenging and fascinating. judgemental environment where men can share and I enjoy the problem solving with our people and connect with others that may be experiencing the exploring what best suits their needs. Knowing I same issues they are. have an incredibly supportive, knowledgeable team around me is invaluable. Breaking down barriers for people to access mental health care and services is a motivation for myself going forward, reaching our remote communities that may be missing out.

EBPHA | GENERAL PRACTICE | COMMUNITY 21 Marina Maxwell

My name is Marina Maxwell, and after being away for It has been a huge 8 years, I have recently returned home to Whakatāne learning curve, and to join the counselling team here at EBPHA. challenge within each I grew up in Tāneatua with my whānau, and I am the role I have had. I have 4th child out of 5. After completing my schooling often been the youngest in Whakatāne, I studied and gained a Bachelor of clinician in the team, and Occupational Therapy through Otago Polytech for with that, seen as the 4 years, with a postgraduate certificate in mental clinician with the least health and addictions. I have now been in the mental skills and experience. health & addiction workforce for around 5 years, and It has also been a great thoroughly enjoy connecting and working alongside challenge working in team environments where there people from all different walks of life. is greater emphasis on the medical model rather than the holistic model and approach to client recovery. I began my career path in a high and complex needs residential facility in the Waikato, and then went My professional and long-term goals was to gain a on to complete a new graduate internship at the role in primary mental health, as I felt this is the area Tauranga mental health inpatient ward. I discovered I where we can make the most difference as clinicians, connected better with younger adults and teenagers as there is more space for preventative therapy. and pursued a fixed term role at a Kaupapa Māori Moving back home, joining the team at EBPHA, and mental health service for children and adolescents. serving my home community has been my best move I continued this pathway and gained a role at Lakes to date. The team truly works from a holistic approach District Health Board in Rotorua as a key worker and values the age and life stage of each clinician at the infant child and adolescent mental health that works here, drawing out each other’s strengths community service. and matching the people we serve to our unique skill sets. Due to this, I have never felt more comfortable and valued in a role before, and this in turn makes me feel very motivated to support our people the best I can. I am excited to be home and excited to see what the future holds.

22 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Service Successes Outreach Immunisation Service

COVID-19 - Keep Calm and Keep Vaccinating

During COVID-19 lock-down the Outreach Immunisation Team continued as an essential service. Many changes were to ensure the safety of ourselves and the babies, children, hapū mamas and elderly when vaccinating.

Pictured is Nurse Deena Royal working out of our mobile vaccination unit to avoid going into people’s homes and bubbles. Clients would come out onto their deck or step to be vaccinated. Some would set up seats outside their homes and we provided little chairs as well if needed.

EBPHA | GENERAL PRACTICE | COMMUNITY 23 Integrated Case Management

Natasha Manuel

EBPHA’s Integrated Case Management Team support the 9 General Practices in the Eastern Bay of Plenty and their patients who have long term chronic or complex conditions, minimising “did not attend” DNA and increasing Immunisation rates. The service aims to support clients and their whānau, to better self-manage, access supports and services removing any barriers. ICM Client story

John is Māori aged 63 with Type 2 Diabetes and recently had cardiac surgery. Recovery was going well which included healthy eating, walking to the pools, and doing aqua aerobics while attending pulmonary rehab once a week. During COVID lockdown John experienced swelling in his abdomen and increased SOB, his BGL also increased from which was once 4-6 to 21.

With support from his GP, a change in medication and increased BGL monitoring before and after ICM Welcome new staff member every meal, he was becoming hōha. However, John was able to get a Freestyle Libre Flash Glucose We would also like to welcome Walter Harawira to Monitoring System which he trialed for 2 weeks. With our team who joins us 2 days a week. Walter is no his families’ support, recording became very easy. He stranger to EBPHA, he was with our Hapainga Stop shared the results with his GP who was very excited Smoking team for many years. Walters relationship about this because he was testing more than needed. networks and local knowledge will be greatly valued John said, “Because it didn’t hurt, my phone did all in our team and community the work”. Johns BGL also came down through the 2-week trial to 8. ICM INTERNATIONAL ICM & Immunisation Presented at the 18th International Conference on Integrated Care, Utrecht, Netherlands 23-25th May As a new initiative or addition to ICM contract, 2018, the ICM abstract was nominated and short- ICM are now able to support General Practice to listed for an award. ICM placed in the top 6 out of increase their immunisation rate for babies that 183 abstracts from around the world with the criteria need to be enrolled at a general practice or book based on innovation, relevant and impactful. Still an appointment with GP or receive support from today, queries about the ICM model of care are still Outreach immunisation service coming from around the world.

24 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Hāpainga Stop Smoking Service

Sharlene Maru-Habib & Hapū Māmā Programme During the last year, the Hāpainga Stop Smoking “Being part of the Service has seen many changes to the team. Hāpainga Team has been They continued to provide a hIgh quality service rewarding because I throughout the year, including during the Covid-19 can see how I can help lockdown period when many of the team members whānau QUIT smoking. were involved working on the frontline at the It’s hard work and takes Whakatāne CBAC. a lot of support. That is where we, the team, can One of the new team members is Sharlene Maru- help.” Habib, who has taken up the role of Hapū Māmā Champion. Shar has spent most of her llfe in The Hapū Māmā Whakatāne and is able to use her invaluable programme has now been extended to those caring connections to reach out to young māmā locally and full-time for tamariki under the age of 3, in line with support them in starting their quit journey. the First Thousand Days initiative. Those successfully quitting can receive up to $250 in vouchers. They can Ko Pokaituna te maunga also identify a ‘Quit Buddy’ who will receive up to Ko Ōhinemataroa te awa $150 in vouchers if they also quit. Ko Rangimārie te Marae Ko Ngāti Rarawhati te hapū Ko Rauporoa te whenua Ko Ngāti Pūkeko, Ngāti Awa ngā Iwi Ko Mataatua te waka Ko Sharlene Maru-Habib tōku ingoa

EBPHA | GENERAL PRACTICE | COMMUNITY 25 Financial statements Eastern Bay Primary Health Alliance For the year ended 30 June 2020

Contents

DIRECTORY...... 27 INDEPENDENT AUDITOR’S REPORT...... 28 STATEMENT OF COMPREHENSIVE REVENUE AND EXPENSES...... 30 STATEMENT OF CHANGES IN NET ASSETS...... 31 STATEMENT OF FINANCIAL POSITION...... 32 CASHFLOW STATEMENT...... 33 NOTES TO THE FINANCIAL STATEMENTS...... 34

26 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT Directory Eastern Bay Primary Health Alliance For the year ended 30 June 2020

Chief Executive Greig Dean (appointed 13 May 2019)

Chairman Ken Whelan (resigned 30 March 2020) Lance McNicholas (interim)

Board of Trustees Fiona Wiremu (appointed 27 October 2017) Erin Beeler (appointed 25 May 2016) Angela Jackson (appointed 26 September 2012) Linda Steel (appointed 29 July 2010) Shaneen Almond-Simpson (appointed 24 January 2018) Lance McNicholas (appointed 17 April 2019) Dickie Farrar (appointed 17 April 2019) Dr Chris McKnight (appointed 19 June 2019) Dr Niles Giles (appointed 27 April 2020) Amohaere Tangitu (resigned 28 January 2020)

Location 5 Louvain Street Whakatane

Banker ASB Bank Limited Shortland Street, Auckland

Accountant Switch Accountants (2017) Limited 22 Louvain Street, Whakatane 3120 New Zealand

Auditors William Buck Audit (NZ) Limited The Kollective 145 Seventeenth Avenue, Tauranga 3112 New Zealand

Solicitors Burley Attwood Law 41 Monmouth Street, Tauranga 3110 New Zealand

EBPHA | GENERAL PRACTICE | COMMUNITY 27

Eastern Bay Primary Health Alliance

Independent auditor’s report to the Board of Trustees Eastern Bay Primary Health Alliance Report on the Financial Statements Independent auditor’s report to the Board of Trustees Eastern Bay Primary Health Alliance Report on the Financial Statements IndependentOpinion auditor’s report to the Board of Trustees

WeReport have audited on the the financial Financial statements Statements of Eastern Bay Primary Health Alliance (the Opinionentity), which comprise the statement of financial position as at 30 June 2020, and the statement of comprehensive revenue and expense, statement of changes in net assets We haveand statement audited the of financialcash flows statem for theents year of Easternthen ended, Bay andPrimary notes Health to the Alliance financial (the entity),Opinionstatements, which comprise including the a statementsummary ofof significantfinancial position accounting as at policies. 30 June 2020, and the statement of comprehensive revenue and expense, statement of changes in net assets We have audited the financial statements of Eastern Bay Primary Health Alliance (the and Instatement our opinion of cash accompanying flows for the financial year th statementsen ended, and give notes a true to and the fairfinancial view of the financial entity), which comprise the statement of financial position as at 30 June 2020, and the statements,position includingof Eastern a Baysummary Primary of significantHealth Alliance accounting as at 30 policies. June 2020 and of its financial statement of comprehensive revenue and expense, statement of changes in net assets performance, and cash flows for the year then ended in accordance with Public Benefit and statement of cash flows for the year then ended, and notes to the financial In ourEntity opinion International accompanying Public financialSector Accounting statements Standards give a true Reduced and fair viewDisclosure of the Regimefinancial statements, including a summary of significant accounting policies. position(IPSAS of Eastern RDR). Bay Primary Health Alliance as at 30 June 2020 and of its financial performance, and cash flows for the year then ended in accordance with Public Benefit In our opinion accompanying financial statements give a true and fair view of the financial Entity International Public Sector Accounting Standards Reduced Disclosure Regime Basisposition for of EasternOpinion Bay Primary Health Alliance as at 30 June 2020 and of its financial (IPSAS RDR). performance, and cash flows for the year then ended in accordance with Public Benefit

EntityWe conducted International our auditPublic in Sector accordance Accounting with International Standards Reduced Standards Disclosure on Auditing Regime (New Basis(IPSASZea forland) Opinion RDR) (ISAs. (NZ). Our responsibilities under those standards are further described in the Auditor’s Responsibilities for the Audit of the Financial Statements section of our We conductedreport. We ourare auditindependent in accordance of the entity with Internationalin accordance Standards with Professional on Auditing and (New Ethical Zealand)BasisStandard (ISAs for 1 Opinion(Revised)(NZ). Our responsibilitiesCode of Ethics forunder Assurance those standards Practitioners are further issued described by the New in the Auditor’sZealand AuditingResponsibilities and Assurance for the Audit Standards of the Board,Financial and Statements we have fulfilled section our of otherour ethical We conducted our audit in accordance with International Standards on Auditing (New report.responsibilities We are independent in accordance of the withentity these in accordance requirements. with WeProfessional believe that and the Ethical audit evidence Zealand) (ISAs (NZ). Our responsibilities under those standards are further described in Standardwe have 1 (Revised) obtained Codeis sufficient of Ethics and for appropriate Assurance to Practitioners provide a basis issued for ourby the opinion. New the Auditor’s Responsibilities for the Audit of the Financial Statements section of our Zealand Auditing and Assurance Standards Board, and we have fulfilled our other ethical report. We are independent of the entity in accordance with Professional and Ethical responsibilitiesOther than in ouraccordance capacity withas auditor these requirements.we have no relationship We believe with, that or the interests audit evidence in, the Standard 1 (Revised) Code of Ethics for Assurance Practitioners issued by the New we haveentity. obtained is sufficient and appropriate to provide a basis for our opinion. Zealand Auditing and Assurance Standards Board, and we have fulfilled our other ethical

responsibilities in accordance with these requirements. We believe that the audit evidence OtherInformation than in our capacity Other than as auditor the Financial we have no Statements relationship with,and orAuditor’s interests Reportin, the we have obtained is sufficient and appropriate to provide a basis for our opinion. entity.Thereon

TheOther Board than ofin ourTrustees capacity is responsible as auditor wefor havethe other no relationship information. with, The or other interests information in, the Information Other than the Financial Statements and Auditor’s Report entity.comprises the reports on pages 1 to 25, but does not include the financial statements and Thereonour auditor’s report thereon.

Information Other than the Financial Statements and Auditor’s Report The OurBoard opinion of Trustees on the isfinancial responsible statements for the does other not information. cover the Theother other information information and we do comprisesThereonnot express the reports any form on pagesof audit 1 opinionto 25, but or doesassurance not include conclusion the financial thereon statements. and our auditor’s report thereon. The Board of Trustees is responsible for the other information. The other information Our comprisesopinion on thethe reportsfinancial on statements pages 1 to does 25, but not does cover not the include other informationthe financial and statements we do and not expressour auditor’s any formreport of ther auditeon. opinion or assurance conclusion thereon.

Our opinion on the financial statements does not cover the other information and we do

not express any form of audit opinion or assurance conclusion thereon.

28 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT

Eastern Bay Primary Health Alliance

Independent auditor’s report to the Board of Trustees In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial Report on the Financial Statements statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If, based on the work we have performed, we conclude that there is a material misstatement of this other Eastern Bay Primary Health Alliance information, we are required to report that fact. We have nothing to report in this regard.

Opinion Independent auditor’s report to the Board of Trustees Responsibilities of the Trustees

We have audited the financial statements of Eastern Bay Primary Health Alliance (the Report on the Financial Statements The Trustees are responsible on behalf of the entity for the preparation of the financial statements that give entity), which comprise the statement of financial position as at 30 June 2020, and the a true and fair view in accordance with Public Benefit Entity International Public Sector Accounting statement of comprehensive revenue and expense, statement of changes in net assets Standards, and for such internal control as the Trustees determine is necessary to enable the preparation and statement of cash flows for the year then ended, and notes to the financial of the financial statements that is free from material misstatement, whether due to fraud or error. Opinionstatements, including a summary of significant accounting policies.

In preparing the financial statements, the Trustees are responsible on behalf of the entity for assessing the WeIn our have opinion audited accompanying the financial financial statements statements of Eastern give Bay a true Primary and fairHealth view Alliance of the financial(the entity’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern entity),position which of Eastern comprise Bay thePrimary statement Health of Alliance financial as position at 30 June as at 2020 30 June and 20of 20its ,financial and the and using the going concern basis of accounting unless the Trustees either intend to liquidate the entity or statementperformance, of comprehensive and cash flows revenuefor the year and then expense, ended statement in accordance of changes with Public in net Benefit assets to cease operations, or have no realistic alternative but to do so. andEntity statement International of cash Public flows Sector for the Accounting year then Standardsended, and Reduced notes to Disclosurethe financial Regime statements,(IPSAS RDR) including. a summary of significant accounting policies. Auditor’s Responsibilities for the Audit of the Financial Statements

In our opinion accompanying financial statements give a true and fair view of the financial Our objectives are to obtain reasonable assurance about whether the financial statements are as a whole Basisposition for of EasternOpinion Bay Primary Health Alliance as at 30 June 2020 and of its financial free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes performance, and cash flows for the year then ended in accordance with Public Benefit our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit WeEntity conducted International our auditPublic in Sector accordance Accounting with International Standards Reduced Standards Disclosure on Auditing Regime (New conducted in accordance with ISAs (NZ) will always detect a material misstatement when it exists. Zea(IPSASland) RDR) (ISAs. (NZ). Our responsibilities under those standards are further described in Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, the Auditor’s Responsibilities for the Audit of the Financial Statements section of our report. We are independent of the entity in accordance with Professional and Ethical they could reasonably be expected to influence the economic decisions of users taken on the basis of these BasisStandard for 1 Opinion(Revised) Code of Ethics for Assurance Practitioners issued by the New financial statements. Zealand Auditing and Assurance Standards Board, and we have fulfilled our other ethical responsibilitiesWe conducted ourin accordance audit in accordance with these with requirements. International We Standards believe thaton Auditing the audit (New evidence A further description of our responsibilities for the audit of these financial statements is located at the weZea haveland) obtained(ISAs (NZ). is sufficient Our responsibilities and appropriate under to those provide standards a basis arefor ourfurther opinion. described in External Reporting Board (XRB) website at: the Auditor’s Responsibilities for the Audit of the Financial Statements section of our https://www.xrb.govt.nz/standards-for-assurance-practitioners/auditors-responsibilities/audit-report/8 Otherreport. than We arin eour independent capacity as of auditor the entity we inhave accordance no relationship with Professional with, or interests and Ethical in, the This description forms part of our independent auditor’s report. entity.Standard 1 (Revised) Code of Ethics for Assurance Practitioners issued by the New Zealand Auditing and Assurance Standards Board, and we have fulfilled our other ethical The engagement director on the audit resulting in this independent auditor’s report is Richard Dey. Informationresponsibilities Other in accordance than the with Financial these requirements. Statements We and believe Auditor’s that the Report audit evidence Thereonwe have obtained is sufficient and appropriate to provide a basis for our opinion. Restriction on Distribution and Use

OtherThe Board than ofin ourTrustees capacity is responsible as auditor wefor havethe other no relationship information. with, The or other interests information in, the This report is made solely to the trustees, as a body. Our audit work has been undertaken so that we might entity.comprises the reports on pages 1 to 25, but does not include the financial statements and state to the trustees those matters which we are required to state to them in an auditor’s report and for no our auditor’s report thereon. other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone Information Other than the Financial Statements and Auditor’s Report other than the entity and the trustees, as a body, for our audit work, for this report or for the opinions we Our opinion on the financial statements does not cover the other information and we do have formed. Thereonnot express any form of audit opinion or assurance conclusion thereon.

The Board of Trustees is responsible for the other information. The other information comprises the reports on pages 1 to 25, but does not include the financial statements and our auditor’s report thereon.

Our opinion on the financial statements does not cover the other information and we do William Buck Audit (NZ) Limited not express any form of audit opinion or assurance conclusion thereon. Tauranga 13 October 2020

EBPHA | GENERAL PRACTICE | COMMUNITY 29

30 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT EBPHA | GENERAL PRACTICE | COMMUNITY 31 32 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT EBPHA | GENERAL PRACTICE | COMMUNITY 33 34 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT EBPHA | GENERAL PRACTICE | COMMUNITY 35 36 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT EBPHA | GENERAL PRACTICE | COMMUNITY 37 38 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT EBPHA | GENERAL PRACTICE | COMMUNITY 39 40 2019 EASTERN BAY PRIMARY HEALTH ALLIANCE - ANNUAL REPORT

EASTERN BAY PRIMARY HEALTH ALLIANCE CONTACT: 07 306 2300

Registered Office: 5 Louvain Street, Whakatāne

Postal Address: PO Box 664, Whakatāne 3158

Email: [email protected] Web: www.ebpha.org.nz